Individual provider Active NPI

Myka Loos

  • Massage Therapist
  • Lake City, FL
National Provider Identifier
1093582165
Registry record updated Dec 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Massage TherapistTaxonomy code 225700000X
License
MA91173 Issued in FL
Practice address
415 S Marion Ave
Lake City, FL 32025-5270
Phone
(386) 209-5750
NPI assigned
Dec 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Massage Therapist 225700000X MA91173 FL Primary

Addresses

Primary practice location

415 S Marion Ave
Lake City, FL 32025-5270

Mailing address

323 S Marion Ave
Lake City, FL 32025-7065

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MA91173FLMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Le Fleur Wellness LLC Massage Therapist CurrentSince Dec 17, 2023 Accepting new patients

Locations

323 S Marion Ave
Lake City, FL 32025
Phone (386) 209-5750

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701907200000",
    "number": "1093582165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320257065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S MARION AVE",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320255270",
            "telephone_number": "386-209-5750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOOS",
        "first_name": "MYKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-07",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "FL",
            "license": "MA91173",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.